According to the Joint Commission, 1,102 wrong-patient, wrong-site or wrong-procedure surgeries occurred from 2004 through 2014, even though they are preventable.
In a recent piece for Periop Insider, the Association of periOperative Registered Nurses outlined the top nine reasons that could lead to a wrong-site surgery, broken down in three categories. They are:
During surgical booking
- Errors on the booking form or illegible information
- An unapproved form was used for booking
- The booking form was not received within 48 hours of surgery
During pre-op
- Inadequate patient verification by surgeon
- Inadequate patient verification by anesthesia provider
- Documents like consent, history and physical, surgeon booking orders or OR schedule were missing or incorrect
In the OR
- Patient's name, identifier and intended procedure were not read
- Team members did not stop talking and activities without being prompted from a team member
- No one visually and verbally confirmed the correct site mark during time out
AORN pulled this information from data from the Targeted Solutions Tool for Safe Surgery from the Joint Commission.